Provider Demographics
NPI:1447789730
Name:SALEYMA HEALTH MED WAIVER SERVICES, LLC
Entity Type:Organization
Organization Name:SALEYMA HEALTH MED WAIVER SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRITZ
Authorized Official - Middle Name:MASSON
Authorized Official - Last Name:ALEXANDRE
Authorized Official - Suffix:
Authorized Official - Credentials:RMA, MPH
Authorized Official - Phone:321-888-1371
Mailing Address - Street 1:1302 SW PAAR DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-6155
Mailing Address - Country:US
Mailing Address - Phone:321-888-1371
Mailing Address - Fax:772-408-0574
Practice Address - Street 1:1302 SW PAAR DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-6155
Practice Address - Country:US
Practice Address - Phone:321-888-1371
Practice Address - Fax:772-408-0574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services